The Patient Protection and Affordable Care Act, often referred to simply as the ACA or Obamacare, was signed into law on March 23, 2010. The ACA is intended to expand access to health insurance coverage for millions of uninsured Americans by expanding eligibility for Medicaid and developing health insurance marketplaces where uninsured persons may be eligible for subsidies to make private health plans more affordable. While expanding access to health insurance is a big part of the ACA, there are many other purposes of the law, including provisions intended to reform the health care delivery system to produce better patient outcomes at lower cost.
AOTA was very active in the legislative process leading up to the passage and signing of the ACA, working to achieve victories such as inclusion of rehabilitation and habilitation in the essential health benefits package. AOTA has also been monitorting the regulatory process at the federal and state levels as the ACA has been implemented, and has been advocating for occupational therapy practitioners and consumers. The dynamic environment created by health care reform creates opportunities, but vigilant monitoring of implementation activities and carefully executed advocacy efforts are necessary to ensure occupational therapy is valued and protected in the future.
Please also see the Health Care Reform Implementation page on AOTA's website at: http://www.aota.org/Advocacy-Policy/Health-Care-Reform.aspx
CHIP, the federal-state program that covers almost 9 million children from low- and moderate-income families, expired on September 30, 2017. Since then states have been using leftover funds to keep their CHIP programs going, and the federal government has redistributed some unspent CHIP funds to especially hard-pressed states. But the money that has allowed them to stretch the program for a few extra months is running out.
This week, Colorado started sending letters to CHIP families informing them that their CHIP coverage might terminate at the end of January, and advising them to start researching other options. Other states are expected to do the same thing soon.
Health policy watchers have long assumed that CHIP would be reauthorized this year, because the 20-year-old program has usually had bipartisan support. Most still think that Congress will reauthorize the program by the end of the year. But states have to base their actions on the law as it is now, so right now states are preparing to shut CHIP down.
This Medicaid and CHIP Payment and Access Commission (MACPAC) fact sheet includes a chart listing each state and the month it is projected to exhaust CHIP funding. Twenty-eight states are expected to run out during the first three months of 2018.
It is still probable that Congress will pass a CHIP bill soon. The House of Representatives passed a bill extending CHIP and community health center funding on November 3. The House bill would extend CHIP for five years. Now it is in the Senate’s hands.
Check out the National Academy for State Health Policy (NASHP) and the Kaiser Family Foundation for resources on CHIP in the states.
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